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(b) T ABLE OF CONTENTS.—The table of contents for1

this Act is as follows:2

Sec. 1. Short title; table of contents.

TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH

Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders.

Sec. 102. Interagency Serious Mental Illness Coordinating Committee.

Sec. 103. Assisted outpatient treatment grant program.

Sec. 104. Tele-psychiatry and primary care physician training grant program.

TITLE II—FEDERALLY QUALIFIED BEHAVIORAL HEALTH

CLINICS

Sec. 201. Demonstration program to improve federally qualified community be-

havioral health clinic services.

TITLE III—HIPAA AND FERPA CAREGIVERS

Sec. 301. Promoting appropriate treatment for mentally ill individuals by treat-

ing their caregivers as personal representatives for purposes of

HIPAA privacy regulations.

Sec. 302. Caregivers permitted access to certain education records under

FERPA.

TITLE IV—DEPARTMENT OF JUSTICE REFORMS

Sec. 401. Additional purposes for certain Federal grants.

Sec. 402. Reauthorization and additional amendments to the Mentally Ill Of-

fender Treatment and Crime Reduction Act.

Sec. 403. Assisted outpatient treatment.

Sec. 404. Improvements to the Department of Justice data collection and re-porting of mental illness in crime.

Sec. 405. Reports on the number of seriously mentally ill who are imprisoned.

TITLE V—MEDICARE AND MEDICAID REFORMS

Sec. 501. Enhanced Medicaid coverage relating to certain mental health serv-

ices.

Sec. 502. Access to mental health prescription drugs under Medicare and Med-

icaid.

TITLE VI—RESEARCH BY NATIONAL INSTITUTE OF MENTAL

HEALTH

Sec. 601. Increase in funding for certain research.

TITLE VII—COMMUNITY MENTAL HEALTH SERVICES BLOCK

GRANT REFORM

Sec. 701. Administration of block grants by Assistant Secretary.

Sec. 702. Additional program requirements.

Sec. 703. Period for expenditure of grant funds.

Sec. 704. Treatment standard under State law.

Sec. 705. Assisted outpatient treatment under State law.

Sec. 706. Best available science and models of care.

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Sec. 707. Paperwork reduction study.

TITLE VIII—BEHAVIORAL HEALTH AWARENESS PROGRAM

Sec. 801. Reducing the stigma of serious mental illness.

TITLE IX—BEHAVIORAL HEALTH INFORMATION TECHNOLOGY

Sec. 901. Extension of health information technology assistance for behavioral

and mental health and substance abuse.

Sec. 902. Extension of eligibility for Medicare and Medicaid health information

technology implementation assistance.

TITLE X—EXPANDING ACCESS TO CARE THROUGH HEALTH

CARE PROFESSIONAL VOLUNTEERISM

Sec. 1001. Liability protections for health care professional volunteers at com-

munity health centers and federally qualified community behav-

ioral health clinics.

TITLE XI—SAMHSA REAUTHORIZATION AND REFORMS

Subtitle A—Organization and General Authorities

Sec. 1101. In general.

Sec. 1102. Advisory councils.

Sec. 1103. Peer review.

Sec. 1104. Data collection.

Subtitle B—Center for Mental Health Services

Sec. 1111. Center for Mental Health Services.

Sec. 1112. Reauthorization of priority mental health needs of regional and na-

tional significance.

Sec. 1113. Garrett Lee Smith Reauthorization.

Subtitle C—Children With Serious Emotional Disturbances

Sec. 1121. Comprehensive community mental health services for children with

serious emotional disturbances.

Sec. 1122. General provisions; report; funding.

Subtitle D—Projects for Children and Violence

Sec. 1131. Children and violence.

Sec. 1132. Reauthorization of National Child Traumatic Stress Network.

Subtitle E—Protection and Advocacy for Individuals With Mental Illness

Sec. 1141. Prohibition against lobbying by systems accepting Federal funds to

protect and advocate the rights of individuals with mental ill-

ness.

Subtitle F—Limitations on Authority

Sec. 1151. Limitations on SAMHSA programs.

Sec. 1152. Elimination of unauthorized SAMHSA programs.


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TITLE I—ASSISTANT SECRETARY1

FOR MENTAL HEALTH2

SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH3

AND SUBSTANCE USE DISORDERS.4

Title V of the Public Health Service Act is amended5

by inserting after section 501 of such Act (42 U.S.C.6

290aa) the following:7

‘‘SEC. 501A. ASSISTANT SECRETARY FOR MENTAL HEALTH8

AND SUBSTANCE USE DISORDERS.9

‘‘(a) IN GENERAL.—There shall be in the Depart-10

ment of Health and Human Services an official to be11

known as the Assistant Secretary for Mental Health and12

Substance Use Disorders (in this section referred to as13

the ‘Assistant Secretary’), who shall—14

‘‘(1) report directly to the Secretary;15

‘‘(2) be appointed by the Secretary, by and with16

the advice and consent of the Senate; and17

‘‘(3) be selected from among individuals who—18

‘‘(A)(i) have a doctoral degree in medicine19

or osteopathic medicine and clinical and re-20

search experience in psychiatry;21

‘‘(ii) graduated from an Accreditation22

Council for Graduate Medical Education-cer-23

tified psychiatric residency program; and24


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‘‘(iii) have an understanding of biological,1

psychosocial, and pharmaceutical treatments of2

mental illness; or3

‘‘(B) have a doctoral degree in psychology4

with—5

‘‘(i) clinical and research experience;6

and7

‘‘(ii) an understanding of biological,8

psychosocial, and pharmaceutical treat-9

ments of mental illness.10

‘‘(b) RELATION TO SAMHSA A DMINISTRATOR.—The11

Administrator of the Substance Abuse and Mental Health12

Services Administration shall be under the supervision and13

direction of the Assistant Secretary.14

‘‘(c) DUTIES.—The Assistant Secretary shall—15

‘‘(1) promote the coordination of service pro-16

grams conducted by other departments, agencies, or-17

ganizations, and individuals that are or may be re-18

lated to the problems of individuals suffering from19

substance abuse and mental illness;20

‘‘(2) carry out any functions within the Depart-21

ment of Health and Human Services—22

‘‘(A) to improve the treatment of, and re-23

lated services to, individuals with respect to24

substance abuse and mental illness;25


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‘‘(B) to improve prevention services for1

such individuals; and2

‘‘(C) to protect the legal rights of individ-3

uals with mental illnesses and individuals who4

are substance abusers;5

‘‘(3) carry out the administrative and financial6

management, policy development and planning, eval-7

uation, knowledge dissemination, and public infor-8

mation functions that are required for the implemen-9

tation of mental health programs, including block10

grants, treatments, and data collection;11

‘‘(4) ensure that the Substance Abuse and Men-12

tal Health Services Administration conducts and co-13

ordinates demonstration projects, evaluations, and14

service system assessments and other activities nec-15

essary to improve the availability and quality of16

treatment, prevention, and related services related to17

substance abuse;18

‘‘(5) within the Department of Health and19

Human Services, oversee and coordinate all pro-20

grams and activities relating to the prevention of, or21

treatment or rehabilitation for, mental health or22

substance use disorders;23

‘‘(6) across the Federal Government—24


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‘‘(A) review programs and activities de-1

scribed in paragraph (5);2

‘‘(B) identify any such programs and ac-3

tivities that are duplicative; and4

‘‘(C) formulate recommendations for the5

coordination and improvement of such pro-6

grams and activities; and7

‘‘(7) supervise data collection for and dissemi-8

nate best practices by the National Mental Health9

Policy Laboratory.10

‘‘(d) PRIORITIZATION OF INTEGRATION OF SERVICES 11

AND E ARLY DIAGNOSIS AND INTERVENTION.—In car-12

rying out the duties described in subsection (c), the Assist-13

ant Secretary shall prioritize—14

‘‘(1) the integration of services for the purpose15

of preventing, treating, or providing rehabilitation16

for the prevention of, and treatment or rehabilitation17

for, mental health or substance use disorders with18

primary care services; and19

‘‘(2) early diagnosis and intervention services20

for the prevention of, and treatment or rehabilitation21

for, serious mental health or substance use dis-22

orders.23

‘‘(e) N ATIONAL MENTAL HEALTH POLICY L ABORA -24

TORY .—25


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‘‘(1) IN GENERAL.—The Assistant Secretary for1

Mental Health and Substance Use Disorders shall2

establish, within the Office of the Assistant Sec-3

retary, the National Mental Health Policy Labora-4

tory (in this section referred to as the ‘NMHPL’),5

to be headed by a Director.6

‘‘(2) DUTIES.—The Director of the NMHPL7

shall—8

‘‘(A) identify and implement policy9

changes and other trends likely to have the10

most significant impact on mental health serv-11

ices and monitor their impact in accordance12

with the principles outlined in National Advi-13

sory Mental Health Council’s 2006 report enti-14

tled ‘The Road Ahead: Research Partnerships15

To Transform Services’;16

‘‘(B) collect information from grantees17

under programs established or amended by the18

Helping Families in Mental Health Crisis Act19

of 2013 and under other mental health pro-20

grams under this Act, including grantees that21

are federally qualified community behavioral22

health clinics certified under section 201 of the23

Helping Families in Mental Health Crisis Act24

of 2013 and States receiving funds under a25


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block grant under part B of title XIX of this1

Act; and2

‘‘(C) evaluate and disseminate to such3

grantees evidence-based practices and services4

delivery models using the best available science5

shown to reduce program expenditures while en-6

hancing the quality of care furnished to individ-7

uals by other such grantees.8

‘‘(3) E VIDENCE-BASED PRACTICES AND SERV -9

ICE DELIVERY MODELS.—In selecting evidence-based10

practices and services delivery models for evaluation11

and dissemination under paragraph (2)(C), the Di-12

rector of the NMHPL—13

‘‘(A) shall give preference to models that14

improve the coordination, quality, and efficiency15

of health care services furnished to individuals16

with serious mental illness; and17

‘‘(B) may include clinical protocols and18

practices used in the Recovery After Initial19

Schizophrenia Episode (RAISE) project and the20

North American Prodrome Longitudinal Study21

(NAPLS) of the National Institute of Mental22

Health.23

‘‘(4) DEADLINE FOR BEGINNING IMPLEMENTA -24

TION.—The Director of the NMHPL shall begin im-25


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duced hospitalization from psychotic epi-1

sodes, and other criteria determined by the2

Assistant Secretary; and3

‘‘(ii) the changes in spending under4

such programs by reason of the model.5

‘‘(B) INFORMATION.—The Assistant Sec-6

retary shall make the results of each evaluation7

under this paragraph available to the public in8

a timely fashion and may establish require-9

ments for States and other entities partici-10

pating in the testing of models under grant pro-11

grams described in paragraph (2)(B) to collect12

information that the Assistant Secretary deter-13

mines is necessary to monitor and evaluate such14

models.15

‘‘(f) E XPANSION OF MODELS.—16

‘‘(1) IN GENERAL.—Taking into account the re-17

sults of evaluations under subsection (e), the Assist-18

ant Secretary may, by rule, as part of the program19

of block grants for community mental health services20

under subpart I of part B of title XIX, provide for21

expanded use across the Nation of service delivery22

models by providers funded under such block grants,23

so long as—24


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‘‘(A) the Assistant Secretary determines1

that such expansion will—2

‘‘(i) reduce spending under such block3

grants without reducing the quality of4

care; or5

‘‘(ii) improve the quality of patient6

care without significantly increasing spend-7

ing; and8

‘‘(B) the Director of the National Institute9

of Mental Health determines that such expan-10

sion would improve the quality of patient care.11

‘‘(2) CONGRESSIONAL REVIEW .—Any rule pro-12

mulgated pursuant to paragraph (1) is deemed to be13

a major rule subject to congressional review and dis-14

approval under chapter 8 of title 5, United States15

Code.16

‘‘(g) REPORTS TO CONGRESS.—Not later than 1 year17

after the date of enactment of this Act, and every 2 years18

thereafter, the Assistant Secretary shall submit a report19

to the Congress—20

‘‘(1) summarizing the activities of the Assistant21

Secretary;22

‘‘(2) analyzing the efficiency and effectiveness23

of Federal programs and activities relating to the24

prevention of, or treatment or rehabilitation for,25


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mental health or substance use disorders, including1

an accounting of the costs of such programs and ac-2

tivities with administrative costs disaggregated from3

the costs of services and care provided;4

‘‘(3) evaluating the impact on public health of5

projects addressing priority mental health needs of6

regional and national significance under section7

520A to determine—8

‘‘(A) whether each such project has re-9

duced the mortality rate, prevalence, and emer-10

gency room visits for persons with serious men-11

tal illness; and12

‘‘(B) the effect of such projects on other13

public health measures;14

‘‘(4) formulating recommendations for the co-15

ordination and improvement of Federal programs16

and activities described in paragraph (2); and17

‘‘(5) identifying any such programs and activi-18

ties that are duplicative.19

‘‘(h) FUNDING.—Of the amounts made available to20

carry out the block grant for community mental health21

services for each of fiscal years 2014 through 2019, not22

more than 5 percent of such amounts are authorized to23

be appropriated to carry out this section.’’.24


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SEC. 102. INTERAGENCY SERIOUS MENTAL ILLNESS CO-1

ORDINATING COMMITTEE.2

Title V of the Public Health Service Act, as amended3

by section 701, is further amended by inserting after sec-4

tion 501A of such Act the following:5

‘‘SEC. 501B. INTERAGENCY SERIOUS MENTAL ILLNESS CO-6

ORDINATING COMMITTEE.7

‘‘(a) ESTABLISHMENT.—The Assistant Secretary for8

Mental Health and Substance Use Disorders (in this sec-9

tion referred to as the ‘Assistant Secretary’) shall estab-10

lish a committee, to be known as the Interagency Serious11

Mental Illness Coordinating Committee (in this section re-12

ferred to as the ‘Committee’), to assist the Assistant Sec-13

retary in carrying out the Assistant Secretary’s duties.14

‘‘(b) RESPONSIBILITIES.—The Committee shall—15

‘‘(1) develop and annually update a summary of16

advances in serious mental illness research related to17

causes, prevention, treatment, early screening, diag-18

nosis or rule out, intervention, and access to services19

and supports for individuals with serious mental ill-20

ness;21

‘‘(2) monitor Federal activities with respect to22

serious mental illness;23

‘‘(3) make recommendations to the Assistant24

Secretary regarding any appropriate changes to such25

activities, including recommendations to the Director26


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of NIH with respect to the strategic plan developed1

under paragraph (5);2

‘‘(4) make recommendations to the Assistant3

Secretary regarding public participation in decisions4

relating to serious mental illness;5

‘‘(5) develop and annually update a strategic6

plan for the conduct of, and support for, serious7

mental illness research, including proposed budg-8

etary requirements; and9

‘‘(6) submit to the Congress such strategic plan10

and any updates to such plan.11

‘‘(c) MEMBERSHIP.—12

‘‘(1) IN GENERAL.—The Committee shall be13

composed of—14

‘‘(A) the Assistant Secretary for Mental15

Health and Substance Use Disorders (or the16

Assistant Secretary’s designee), who shall serve17

as the Chair of the Committee;18

‘‘(B) the Director of the National Institute19

of Mental Health (or the Director’s designee);20

‘‘(C) the Attorney General of the United21

States (or the Attorney General’s designee);22

‘‘(D) the Director of the Centers for Dis-23

ease Control and Prevention (or the Director’s24

designee);25


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‘‘(E) the Director of the National Insti-1

tutes of Health (or the Director’s designee);2

‘‘(F) the directors of such national re-3

search institutes of the National Institutes of4

Health as the Assistant Secretary for Mental5

Health and Substance Use Disorders deter-6

mines appropriate (or their designees);7

‘‘(G) representatives, appointed by the As-8

sistant Secretary, of Federal agencies that are9

outside of the Department of Health and10

Human Services and serve individuals with seri-11

ous mental illness, such as the Department of12

Education;13

‘‘(H) the Administrator of Substance14

Abuse and Mental Health Services Administra-15

tion; and16

‘‘(I) the additional members appointed17

under paragraph (2).18

‘‘(2) A DDITIONAL MEMBERS.—Not fewer than19

9 members of the Committee, or 1 ⁄ 3 of the total20

membership of the Committee, whichever is greater,21

shall be composed of non-Federal public members to22

be appointed by the Assistant Secretary, of which—23

‘‘(A) at least one such member shall be an24

individual with a diagnosis of serious mental ill-25


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ness who has benefitted from and is receiving1

medical treatment under the care of a physi-2

cian;3

‘‘(B) at least one such member shall be a4

parent or legal guardian of an individual with5

a serious mental illness;6

‘‘(C) at least one such member shall be a7

representative of leading research, advocacy,8

and service organizations for individuals with9

serious mental illness;10

‘‘(D) at least one member shall be a psy-11

chiatrist;12

‘‘(E) at least one member shall be a clin-13

ical psychologist;14

‘‘(F) at least one member shall be a judge15

with successful experiences applying assisted16

outpatient treatment;17

‘‘(G) at least one member shall be a law18

enforcement officer; and19

‘‘(H) at least one member shall be a cor-20

rections officer.21

‘‘(d) A DMINISTRATIVE SUPPORT; TERMS OF SERV -22

ICE; OTHER PROVISIONS.—The following provisions shall23

apply with respect to the Committee:24


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necessary to enable the subcommittees to carry out their1

duties.’’.2

SEC. 103. ASSISTED OUTPATIENT TREATMENT GRANT PRO-3

GRAM.4

(a) IN GENERAL.—The Assistant Secretary for Men-5

tal Health and Substance Use Disorders (in this section6

referred to as the ‘‘Assistant Secretary’’), in consultation7

with the Director of the National Institute of Mental8

Health and the Attorney General of the United States,9

shall establish a 4-year pilot program to award not more10

than 50 grants each year to counties, cities, mental health11

systems, mental health courts, and any other entities with12

authority under the law of a State to implement, monitor,13

and oversee assisted outpatient treatment programs. The14

Assistant Secretary may only award grants under this sec-15

tion to applicants that have not previously implemented16

an assisted outpatient treatment program. The Assistant17

Secretary shall evaluate applicants based on their poten-18

tial to reduce hospitalization, homelessness, incarceration,19

and interaction with the criminal justice system while im-20

proving health outcomes, such as adherence to medication21

usage.22

(b) USE OF GRANT.—An assisted outpatient treat-23

ment program carried out with a grant awarded under this24

section shall include—25


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(1) evaluating and seeking out eligible individ-1

uals who may benefit from assisted outpatient treat-2

ment;3

(2) preparing and executing treatment plans for4

eligible patients and filing petitions for assisted out-5

patient treatment in appropriate courts;6

(3) providing case management services to eligi-7

ble patients who are participating in the program to8

provide such patients with resources, monitoring,9

and oversight, including directly monitoring a par-10

ticipant’s level of compliance and the delivery of11

services by other providers pursuant to the court12

order; and13

(4) carrying out referrals and medical evalua-14

tions, and paying the costs of legal counsel for com-15

mitment orders to be submitted and evaluated by16

the courts.17

(c) D ATA COLLECTION.—Grantees under this section18

shall provide in a timely fashion any data collected pursu-19

ant to the grant to the National Mental Health Policy20

Laboratory, as requested by the Assistant Secretary, con-21

cerning health outcomes and treatments.22

(d) REPORT.—The Assistant Secretary shall submit23

an annual report to the Committees on Energy and Com-24

merce and the Judiciary of the House of Representatives,25


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the Committees on Health, Education, Labor, and Pen-1

sions and the Judiciary of the Senate, and the Congres-2

sional Budget Office on the grant program under this sec-3

tion. Each such report shall include an evaluation of the4

following:5

(1) Cost savings and public health outcomes6

such as mortality, suicide, substance abuse, hos-7

pitalization, and use of services.8

(2) Rates of incarceration by patients.9

(3) Rates of employment by patients.10

(4) Rates of homelessness.11

(e) DEFINITIONS.—In this section:12

(1) A SSISTED OUTPATIENT TREATMENT.—The13

term ‘‘assisted outpatient treatment’’ means—14

(A) except as provided in subparagraph15

(B), medically prescribed treatment that an eli-16

gible patient must undergo while living in a17

community under the terms of a law author-18

izing a State or local court to order such treat-19

ment; and20

(B) in the case of a State that does not21

have a law described in subparagraph (A) in ef-22

fect on the date of enactment—23

(i) a court-ordered treatment plan for24

an eligible patient that requires such pa-25


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tient to obtain outpatient mental health1

treatment while the patient is living in a2

community; and3

(ii) is designed to improve access and4

adherence by such patient to intensive be-5

havioral health services in order to—6

(I) avert relapse, repeated hos-7

pitalizations, arrest, incarceration,8

suicide, property destruction, and vio-9

lent behavior; and10

(II) provide such patient with the11

opportunity to live in a less restrictive12

alternative to incarceration or involun-13

tary hospitalization.14

(2) ELIGIBLE PATIENT.—The term ‘‘eligible pa-15

tient’’ means an adult, mentally ill person who, as16

determined by the court—17

(A) has a history of violence, incarceration,18

or medically unnecessary hospitalizations;19

(B) without supervision and treatment,20

may be a danger to self or others in the com-21

munity;22

(C) is substantially unlikely to voluntarily23

participate in treatment;24


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(D) may be unable, for reasons other than1

indigence, to provide for any of his or her basic2

needs, such as food, clothing, shelter, health, or3

safety;4

(E) has a history of mental illness or con-5

dition that is likely to substantially deteriorate6

if the patient is not provided with timely treat-7

ment; or8

(F) due to mental illness, lacks capacity to9

fully understand or lacks judgment to make in-10

formed decisions regarding his or her need for11

treatment, care, or supervision.12

(f) FUNDING.—13

(1) A MOUNT OF GRANTS.—A grant under this14

section shall be in an amount that is not more than15

$1,000,000 for each of grant years 2014 through16

2017. Subject to the preceding sentence, the Assist-17

ant Secretary shall determine the amount of each18

grant based on the population of patients of the area19

to be served under the grant.20

(2) A UTHORIZATION OF APPROPRIATIONS.—21

There is authorized to be appropriated to carry out22

this section $15,000,000 for each of fiscal years23

2014 through 2017.24


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SEC. 104. TELE-PSYCHIATRY AND PRIMARY CARE PHYSI-1

CIAN TRAINING GRANT PROGRAM.2

(a) IN GENERAL.—The Assistant Secretary of Men-3

tal Health and Substance Use Disorders (in this section4

referred to as the ‘‘Assistant Secretary’’) shall establish5

a grant program (in this section referred to as the ‘‘grant6

program’’) under which the Assistant Secretary shall7

award to 10 eligible States (as described in subsection (e))8

grants for carrying out all 3 of the purposes described in9

subsections (b), (c), and (d).10

(b) TRAINING PROGRAM FOR CERTAIN PRIMARY 11

C ARE PHYSICIANS.—For purposes of subsection (a), the12

purpose described in this subsection, with respect to a13

grant awarded to a State under the grant program, is for14

the State to establish a training program to train primary15

care physicians in—16

(1) approved standardized behavioral-health17

screening tools, including—18

(A) Ages and Stages Questionnaires (ASQ:19

SE);20

(B) Brief Infant-Toddler Social and Emo-21

tional Assessment (BITSEA);22

(C) screening for substance abuse, known23

as Car, Relax, Alone, Forget, Friends, Trouble,24

(CRAFFT);25


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(D) screening for autism, known as Modi-1

fied Checklist for Autism in Toddlers (M–2

CAT);3

(E) Parents’ Evaluation of Developmental4

Status (PEDS);5

(F) screening for depression, known as Pa-6

tient Health Questionnaire-9 (PHQ–9);7

(G) Pediatric Symptom Checklist (PSC)8

and Pediatric Symptom Checklist-Youth Report9

(Y–PSC);10

(H) Strengths and Difficulties Question-11

naire (SDQ); and12

(I) any additional areas that the Assistant13

Secretary determines applicable;14

(2) implementing the use of behavioral-health15

screening tools in their practices; and16

(3) knowing what to do when a behavioral-17

health need is identified.18

(c) P AYMENTS FOR MENTAL HEALTH SERVICES 19

PROVIDED BY CERTAIN PRIMARY C ARE PHYSICIANS.—20

(1) For purposes of subsection (a), the purpose21

described in this subsection, with respect to a grant22

awarded to a State under the grant program, is for23

the State to provide, in accordance with this sub-24

section, in the case of a primary care physician that25


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trist or psychologist to such physician with respect1

to such individual through the use of qualified tele-2

health technology for the identification, diagnosis,3

mitigation, or treatment of a mental health disorder4

if such consultation occurs not later than the first5

business day that follows such visit.6

(2) QUALIFIED TELEHEALTH TECHNOLOGY .—7

For purposes of subsection (C)(1), the term ‘‘quali-8

fied telehealth technology’’, with respect to the provi-9

sion of items and services to a patient by a health10

care provider—11

(A) includes the use of interactive audio,12

audio-only telephone conversation, video, or13

other telecommunications technology by a14

health care provider to deliver health care serv-15

ices within the scope of the provider’s practice16

at a site other than the site where the patient17

is located, including the use of electronic media18

for consultation relating to the health care diag-19

nosis or treatment of the patient; and20

(B) does not include the use of electronic21

mail message or facsimile transmission.22

(e) ELIGIBLE STATE.—23

(1) IN GENERAL.—For purposes of this section,24

an eligible State is a State that has submitted to the25


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Assistant Secretary an application under paragraph1

(a) and has been selected under paragraph (3).2

(2) A PPLICATION.—A State seeking to partici-3

pate in the grant program under this section shall4

submit to the Assistant Secretary, at such time and5

in such format as the Assistant Secretary requires,6

an application that includes such information, provi-7

sions, and assurances, as the Assistant Secretary8

may require.9

(3) M ATCHING REQUIREMENT.—The Assistant10

Secretary may not make a grant under the grant11

program unless the State involved agrees, with re-12

spect to the costs to be incurred by the State in car-13

rying out the purpose described in this section, to14

make available non-Federal contributions (in cash or15

in kind) toward such costs in an amount equal to16

not less than 20 percent of Federal funds provided17

in the grant.18

(4) SELECTION.—A State shall be determined19

eligible for the grant program by the Assistant Sec-20

retary on a competitive basis among States with ap-21

plications meeting the requirements of paragraphs22

(2) and (3). In selecting State applications for the23

grant program, the Secretary shall seek to achieve24

an appropriate national balance in the geographic25


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distribution of grants awarded under the grant pro-1

gram.2

(f) LENGTH OF GRANT PROGRAM.—The grant pro-3

gram established under this section shall be conducted for4

a period of 3 consecutive years.5

(g) A UTHORIZATION OF A PPROPRIATIONS.—Out of6

any funds in the Treasury not otherwise appropriated,7

there is authorized to be appropriated to carry out this8

section, $3,000,000 for each of the fiscal years 20159

through 2017.10

(h) REPORTS.—11

(1) REPORTS.—For each fiscal year that grants12

are awarded under this section, the Assistant Sec-13

retary and the National Mental Health Policy Lab-14

oratory shall conduct a study on the results of the15

grants and submit to the Congress a report on such16

results that includes the following:17

(A) An evaluation of the grant program18

outcomes, including a summary of activities19

carried out with the grant and the results20

achieved through those activities.21

(B) Recommendations on how to improve22

access to mental health services at grantee loca-23

tions.24


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(C) An assessment of access to mental1

health services under the program.2

(D) An assessment of the impact of the3

demonstration project on the costs of the full4

range of mental health services (including inpa-5

tient, emergency and ambulatory care).6

(E) Recommendations on congressional ac-7

tion to improve the grant.8

(2) REPORT.—Not later than December 31,9

2017, the Assistant Secretary and the National10

Mental Health Policy Laboratory shall submit to11

Congress and make available to the public a report12

on the findings of the evaluation under paragraph13

(1) and also a policy outline on how Congress can14

expand the grant program to the national level.15

TITLE II—FEDERALLY QUALI-16

FIED BEHAVIORAL HEALTH17

CLINICS18

SEC. 201. DEMONSTRATION PROGRAM TO IMPROVE FEDER-19

ALLY QUALIFIED COMMUNITY BEHAVIORAL20

HEALTH CLINIC SERVICES.21

(a) ESTABLISHMENT.—Not later than January 1,22

2016, the Secretary of Health and Human Services (re-23

ferred to in this section as the ‘‘Secretary’’), in coordina-24

tion with the Assistant Secretary for Mental Health and25


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Substance Use Disorders, shall award planning grants to1

not to exceed 10 States to enable such States to carry2

out 5-year demonstration programs to improve the provi-3

sion of behavioral health services provided by federally4

qualified community behavioral health clinics in the State.5

(b) ELIGIBILITY .—6

(1) A PPLICATION.—To be eligible to receive a7

grant under subsection (a), a State shall—8

(A) submit to the Secretary an application9

at such time, in such manner, and containing10

such information as the Secretary may require;11

(B) certify to the Secretary that behavioral12

health providers that are provided assistance13

under the demonstration program are federally14

qualified community behavioral health clinics;15

(C) certify to the Secretary that, with re-16

spect to the behavioral health providers pro-17

vided assistance under the demonstration pro-18

gram, not more than 75 percent of the total19

number of such providers are participating pro-20

viders under the State Medicaid plan under title21

XIX of the Social Security Act (42 U.S.C. 139622

et seq.);23

(D) demonstrate the actuarial soundness24

of the demonstration program to be carried out25


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under the grant by providing a detailed esti-1

mate of eligible clinics and Medicaid expendi-2

tures over the entire projected period of the3

demonstration program; and4

(E) comply with any other requirement de-5

termined appropriate by the Secretary.6

(2) W AIVER OF MEDICAID REQUIREMENTS.—In7

approving States to conduct demonstration programs8

under this section, the Secretary shall waive such9

provisions of title XIX of the Social Security Act (4210

U.S.C. 1396 et seq.) as are necessary to conduct the11

demonstration program in accordance with the re-12

quirements of this section, including section13

1902(a)(1) of the Social Security Act (42 U.S.C.14

1396a(a)(1)) (relating to statewideness).15

(c) REQUIREMENTS.—In awarding grants under this16

section, the Secretary shall—17

(1) ensure the geographic diversity of grantee18

States;19

(2) ensure that federally qualified community20

behavioral health clinics in such States that are lo-21

cated in rural areas, as defined by the Secretary,22

and other mental health professional shortage areas23

are fairly and appropriately considered with the ob-24


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jective of facilitating access to mental health services1

in such areas;2

(3) take into account the ability of clinics in3

such States to provide required services, and the4

ability of such clinics to report required data as re-5

quired under this section; and6

(4) take into account the ability of such States7

to provide such required services on a statewide8

basis.9

(d) TREATMENT OF CERTAIN SERVICES PROVIDED 10

BY COMMUNITY BEHAVIORAL HEALTH CLINICS AS MED-11

ICAL A SSISTANCE.—12

(1) IN GENERAL.—For purposes of the dem-13

onstration program under this section, community14

behavioral health clinic services (as defined in sub-15

section (f)(1)) that are provided by federally quali-16

fied community behavioral health clinics receiving17

assistance under this section shall be considered18

medical assistance for purposes of payments to19

States under paragraph (3)(C).20

(2) GRANT CONDITION.—As a condition of re-21

ceiving a grant under this section, a State shall22

agree to provide for payment for community behav-23

ioral health clinic services in accordance with the24


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prospective payment system established by the Sec-1

retary under paragraph (3).2

(3) PROSPECTIVE PAYMENT SYSTEM.—3

(A) IN GENERAL.—Not later than 184

months after the date of enactment of this Act,5

the Secretary shall establish a prospective pay-6

ment system for community behavioral health7

clinic services furnished by a community behav-8

ioral health clinic receiving assistance under9

this section in the same manner as payments10

are required to be made under section 1902(bb)11

of the Social Security Act (42 U.S.C.12

1396a(bb)) for services described in section13

1905(a)(2)(C) of such Act (42 U.S.C.14

1396d(a)(2)(C)) furnished by a federally quali-15

fied health center and services described in sec-16

tion 1905(a)(2)(B) of such Act (42 U.S.C.17

1396d(a)(2)(B)) furnished by a rural health18

clinic.19

(B) REQUIREMENTS.—The prospective20

payment system established by the Secretary21

under subparagraph (A) shall provide that—22

(i) no payment shall be made for in-23

patient care, residential treatment, room24

and board expenses, or any other non-25


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ambulatory services, as determined by the1

Secretary; and2

(ii) no payment shall be made to sat-3

ellite facilities of community behavioral4

health clinics if such facilities are estab-5

lished after the date of enactment of this6

Act.7

(C) P AYMENTS TO STATES.—The Sec-8

retary shall pay each State awarded a grant9

under this section an amount each quarter10

equal to the enhanced FMAP (as defined in11

section 2105(b) of the Social Security Act (4212

U.S.C. 1397dd(b)) but without regard to the13

second and third sentences of that section) of14

the State’s expenditures in the quarter for med-15

ical assistance for community behavioral health16

clinic services provided by federally qualified17

community behavioral health clinics in the State18

that receive assistance under this section. Pay-19

ments to States made under this subparagraph20

shall be considered to have been under, and are21

subject to the requirements of, section 1903 of22

the Social Security Act (42 U.S.C. 1396b).23

(e) A NNUAL REPORT.—24


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(1) IN GENERAL.—Not later than 1 year after1

the date on which the first grants are awarded2

under this section, and annually thereafter, the Sec-3

retary shall submit to Congress an annual report on4

the use of funds provided under the demonstration5

program. Each such report shall include—6

(A) an assessment of access to community-7

based mental health services under the Med-8

icaid program in the States awarded such9

grants;10

(B) an assessment of the quality and scope11

of services provided by federally qualified com-12

munity behavioral health clinics under the13

grants as compared against community-based14

mental health services provided in States that15

are not receiving such grants;16

(C) an assessment of the impact of the17

demonstration programs on the costs of a full18

range of mental health services (including inpa-19

tient, emergency and ambulatory services); and20

(D) a peer-reviewed assessment of the pub-21

lic health impact, including but not limited to22

rates of community mortality, hospitalization,23

and other measures as determined by the Direc-24

tor of the National Institute of Mental Health.25


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(2) RECOMMENDATIONS.—Not later than De-1

cember 31, 2019, the Secretary shall submit to Con-2

gress recommendations concerning whether the dem-3

onstration programs under this section should be4

continued and expanded on a national basis.5

(3) D ATA COLLECTION.—Grantees shall provide6

in a timely fashion any such data to the National7

Mental Health Policy Laboratory, as requested by8

the Assistant Secretary concerning health outcomes9

and treatments.10

(f) CRITERIA FOR FEDERALLY QUALIFIED COMMU-11

NITY BEHAVIORAL HEALTH CLINICS.—12

(1) IN GENERAL.—The Assistant Secretary for13

Mental Health and Substance Use Disorders shall14

certify federally qualified community behavioral15

health clinics as meeting the criteria specified in this16

subsection.17

(2) CRITERIA .—The criteria referred to in this18

subsection are that the clinic performs each of the19

following:20

(A) Provide required primary health serv-21

ices (as defined by the Assistant Secretary for22

Mental Health and Substance Use Disorders).23

(B) Provide services in locations that en-24

sure services will be available and accessible25


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promptly and in a manner which preserves1

human dignity and assures continuity of care.2

(C) Provide services in a mode of service3

delivery appropriate for the target population.4

(D) Provide individuals with a choice of5

service options where there is more than one6

evidence-based treatment.7

(E) Employ a core staff that is sufficiently8

trained in child and adolescent psychiatry or9

psychology.10

(F) Employ a core staff that is sufficiently11

trained in child and adolescent psychiatry, dual12

diagnosis issues, crisis management and sta-13

bilization and interventions with patients at14

high risk for violence.15

(G) Provide services, within the limits of16

the capacities of the center, to any individual17

residing or employed in the service area of the18

center, regardless of the ability of the individual19

to pay.20

(H) Provide, directly or through contract,21

to the extent covered for adults in the State22

Medicaid plan under title XIX of the Social Se-23

curity Act and for children in accordance with24

section 1905(r) of such Act regarding early and25


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periodic screening, diagnosis, and treatment,1

each of the following services:2

(i) Screening, assessment, and diag-3

nosis, including risk assessment.4

(ii) Person-centered treatment plan-5

ning or similar processes, including risk as-6

sessment and crisis planning.7

(iii) Outpatient mental health and8

substance use services, including screening,9

assessment, diagnosis, psychotherapy,10

medication management, and integrated11

treatment for mental illness and substance12

abuse which shall be evidence-based (in-13

cluding cognitive behavioral therapy and14

other such therapies which are evidence-15

based).16

(iv) Outpatient clinic primary care17

screening and monitoring of key health in-18

dicators and health risk (including screen-19

ing for diabetes, hypertension, and cardio-20

vascular disease and monitoring of weight,21

height, body mass index (BMI), blood pres-22

sure, blood glucose or HbA1C, and lipid23

profile).24


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(v) Crisis mental health services, in-1

cluding 24-hour mobile crisis teams, emer-2

gency crisis intervention services, and cri-3

sis stabilization.4

(vi) Targeted case management (serv-5

ices provided by a social worker to assist6

individuals gaining access to needed med-7

ical, social, educational, and other services8

and applying for income security and other9

benefits to which they may be entitled).10

(vii) Psychiatric rehabilitation services11

including skills training, assertive commu-12

nity treatment, family psychoeducation,13

disability self-management, supported em-14

ployment, supported housing services,15

therapeutic foster care services, and such16

other evidence-based practices as the Sec-17

retary may require.18

(viii) Peer support and counselor serv-19

ices and family supports.20

(ix) Supported education and sup-21

ported employment for individuals with se-22

rious mental illness after an initial psy-23

chotic episode.24


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(x) Case management services for in-1

dividuals with serious mental illness after2

an initial psychotic episode.3

(I) Use and share electronic health records4

consistent with other applicable law.5

(J) Be available to provide assisted out-6

patient treatment that is ordered by a State7

court pursuant to a State law described in sec-8

tion 1915(d).9

(K) Be available to participate in research10

projects conducted or supported by the National11

Institute of Mental Health.12

(L) Maintain linkages, and where possible13

enter into formal contracts with the following:14

(i) Federally qualified health centers.15

(ii) Inpatient psychiatric facilities and16

substance use detoxification, post-detoxi-17

fication step-down services, and residential18

programs.19

(iii) Adult and youth peer support and20

counselor services.21

(iv) Family support services for fami-22

lies of children with serious mental or sub-23

stance use disorders.24


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(v) Other community or regional serv-1

ices, supports, and providers, including2

schools, child welfare agencies, juvenile and3

criminal justice agencies and facilities (in-4

cluding mental health courts, local police5

forces, and local jails and other detention6

facilities), housing agencies and programs,7

employers, and other social services such8

as schools and religious organizations.9

(vi) Integrating care with primary10

care services, including, to the extent fea-11

sible, through a common delivery site.12

(vii) Enabling services, including out-13

reach, transportation, and translation.14

(viii) Health and wellness services, in-15

cluding services for tobacco cessation.16

(ix) Adopt models of first episode psy-17

chosis training, supervision, team meet-18

ings, and coordination with adjacent care19

organizations.20

(M) Where feasible, provide outreach and21

engagement to encourage individuals who could22

benefit from mental health care to freely par-23

ticipate in receiving the services described in24

this subsection.25


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(3) RULE OF CONSTRUCTION.—Nothing in this1

section shall be construed as prohibiting States re-2

ceiving funds appropriated through the Community3

Mental Health Services Block Grant under this sub-4

part from financing qualified community programs5

(whether such programs meet the definition of eligi-6

ble programs prior to or after the date of enactment7

of this subsection).8

(g) DEFINITIONS.—In this section:9

(1) COMMUNITY BEHAVIORAL HEALTH CLINIC 10

SERVICES.—The term ‘‘community behavioral health11

clinic services’’ means ambulatory behavioral health12

services of the type described in subparagraphs (I),13

(L), (M), and (N) of subsection (f)(2) that are pro-14

vided by federally qualified community behavioral15

health clinics receiving assistance under this section.16

(2) STATE.—The term ‘‘State’’ has the mean-17

ing given such term for purposes of title XIX of the18

Social Security Act (42 U.S.C. 1396 et seq.).19

(3) FEDERALLY QUALIFIED COMMUNITY BE-20

HAVIORAL HEALTH CLINIC.—The term ‘‘federally21

qualified community behavioral health clinic’’ means22

a federally qualified behavioral health clinic with a23

certification in effect under this section.24


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(h) A UTHORIZATION OF A PPROPRIATIONS.—In order1

to fund State planning grants and the administrative costs2

associated with certifying community behavioral health3

clinics, there is authorized to be appropriated to carry out4

this section, $50,000,000 for fiscal year 2016, to remain5

available until expended.6

TITLE III—HIPAA AND FERPA7

CAREGIVERS8

SEC. 301. PROMOTING APPROPRIATE TREATMENT FOR9

MENTALLY ILL INDIVIDUALS BY TREATING10

THEIR CAREGIVERS AS PERSONAL REP-11

RESENTATIVES FOR PURPOSES OF HIPAA12

PRIVACY REGULATIONS.13

(a) C AREGIVER A CCESS TO INFORMATION.—In ap-14

plying section 164.502(g) of title 45, Code of Federal Reg-15

ulations, to an individual with a serious mental illness who16

does not provide consent for the disclosure of protected17

health information to a caregiver of such individual, the18

caregiver shall be treated by a covered entity as a personal19

representative (as described under such section20

164.502(g)) of such individual with respect to protected21

health information of such individual when the provider22

furnishing services to the individual reasonably believes it23

is necessary for protected health information of the indi-24

vidual to be made available to the caregiver in order to25


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protect the health, safety, or welfare of such individual or1

the safety of one or more other individuals.2

(b) DEFINITIONS.—For purposes of this section:3

(1) COVERED ENTITY .—The term ‘‘covered en-4

tity’’ has the meaning given such term in section5

106.103 of title 45, Code of Federal Regulations.6

(2) PROTECTED HEALTH INFORMATION.—The7

term ‘‘protected health information’’ has the mean-8

ing given such term in section 106.103 of title 45,9

Code of Federal Regulations.10

(3) C AREGIVER.—The term ‘‘caregiver’’ means,11

with respect to an individual with a serious mental12

illness—13

(A) an immediate family member of such14

individual;15

(B) an individual who assumes primary re-16

sponsibility for providing a basic need of such17

individual; or18

(C) a personal representative of the indi-19

vidual as determined by the law of the State in20

which such individual resides.21

(4) INDIVIDUAL WITH A SERIOUS MENTAL ILL-22

NESS.—The term ‘‘individual with a serious mental23

illness’’ means, with respect to the disclosure to a24


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caregiver of protected health information of an indi-1

vidual, an individual who—2

(A) is 18 years of age or older; and3

(B) has, within one year before the date of4

the disclosure, been evaluated, diagnosed, or5

treated for a mental, behavioral, or emotional6

disorder that—7

(i) is determined by a physician to be8

of sufficient duration to meet diagnostic9

criteria specified within the Diagnostic and10

Statistical Manual of Mental Disorders;11

and12

(ii) results in functional impairment13

of the individual that substantially inter-14

feres with or limits one or more major life15

activities of the individual.16

SEC. 302. CAREGIVERS PERMITTED ACCESS TO CERTAIN17

EDUCATION RECORDS UNDER FERPA.18

Section 444 of the General Education Provisions Act19

(20 U.S.C. 1232g) is amended by adding at the end the20

following new subsection:21

‘‘(k) DISCLOSURES TO C AREGIVERS OF THE MEN-22

TALLY ILL.—23

‘‘(1) IN GENERAL.—Nothing in this Act, the24

Elementary and Secondary Education Act of 1965,25


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or the Higher Education Act of 1965 shall be con-1

strued to prohibit an educational agency or institu-2

tion from disclosing, to a caregiver of an individual3

with a serious mental illness who has not explicitly4

provided consent to the agency or institution for the5

disclosure of protected health information, an edu-6

cation record of such individual if a physician, psy-7

chologist, or other recognized mental health profes-8

sional or paraprofessional acting in his or her pro-9

fessional or paraprofessional capacity, or assisting in10

that capacity reasonably believes such disclosure to11

the caregiver is necessary to protect the health, safe-12

ty, or welfare of such individual or the safety of one13

or more other individuals.14

‘‘(2) DEFINITIONS.—In this subsection:15

‘‘(A) C AREGIVER.—The term ‘caregiver’16

means, with respect to an individual with a seri-17

ous mental illness, a family member or imme-18

diate past legal guardian who assumes a pri-19

mary responsibility for providing a basic need20

of such individual (such as a family member or21

past legal guardian of the individual who has22

assumed the responsibility of co-signing a loan23

with the individual).24


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‘‘(B) EDUCATION RECORD.—Notwith-1

standing subsection (a)(4)(B), the term ‘edu-2

cation record’ shall include a record described3

in clause (iv) of such subsection.4

‘‘(C) INDIVIDUAL WITH A SERIOUS MEN-5

TAL ILLNESS.—The term ‘individual with a se-6

rious mental illness’ means, with respect to the7

disclosure to a caregiver of protected health in-8

formation of an individual, an individual who—9

‘‘(i) is 18 years of age or older; and10

‘‘(ii) has, within one year before the11

date of the disclosure, been evaluated, di-12

agnosed, or treated for a mental, behav-13

ioral, or emotional disorder that—14

‘‘(I) is determined by a physician15

to be of sufficient duration to meet di-16

agnostic criteria specified within the17

Diagnostic and Statistical Manual of18

Mental Disorders; and19

‘‘(II) results in functional impair-20

ment of the individual that substan-21

tially interferes with or limits one or22

more major life activities of the indi-23

vidual.’’.24


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TITLE IV—DEPARTMENT OF1

JUSTICE REFORMS2

SEC. 401. ADDITIONAL PURPOSES FOR CERTAIN FEDERAL3

GRANTS.4

(a) MODIFICATIONS TO THE EDWARD B YRNE MEMO-5

RIAL JUSTICE A SSISTANCE GRANT PROGRAM.—Section6

501(a)(1) of title I of the Omnibus Crime Control and7

Safe Streets Act of 1968 (42 U.S.C. 3751(a)(1)) is8

amended by adding at the end the following:9

‘‘(H) Mental health programs and oper-10

ations by law enforcement or corrections offi-11

cers.’’.12

(b) MODIFICATIONS TO THE COMMUNITY ORIENTED 13

POLICING SERVICES PROGRAM.—Section 1701(b) of title14

I of the Omnibus Crime Control and Safe Streets Act of15

1968 (42 U.S.C. 3796dd(b)) is amended—16

(1) in paragraph (16), by striking ‘‘and’’ at the17

end;18

(2) by redesignating paragraph (17) as para-19

graph (19);20

(3) by inserting after paragraph (16) the fol-21

lowing:22

‘‘(17) to provide specialized training to law en-23

forcement officers (including village public safety of-24

ficers (as defined in section 247 of the Indian Arts25


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and Crafts Amendments Act of 2010 (42 U.S.C.1

3796dd note))) to recognize individuals who have2

mental illness and how to properly intervene with in-3

dividuals with mental illness, and to establish pro-4

grams that enhance the ability of law enforcement5

agencies to address the mental health, behavioral,6

and substance abuse problems of individuals encoun-7

tered in the line of duty;8

‘‘(18) to provide specialized training to enhance9

the ability of corrections officers to address the men-10

tal health of individuals under the care and custody11

of jails and prisons; and’’; and12

(4) in paragraph (19), as redesignated, by13

striking ‘‘through (16)’’ and inserting ‘‘through14

(19)’’.15

(c) MODIFICATIONS TO THE STAFFING FOR A DE-16

QUATE FIRE AND EMERGENCY RESPONSE GRANTS.—Sec-17

tion 34(a)(1)(B) of Public Law 93–498 (15 U.S.C.18

2229a(a)(1)(B)) is amended by inserting before the period19

at the end the following: ‘‘and to provide specialized train-20

ing to paramedics, emergency medical services workers,21

and other first responders to recognize individuals who22

have mental illness and how to properly intervene with in-23

dividuals with mental illness’’.24


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SEC. 402. REAUTHORIZATION AND ADDITIONAL AMEND-1

MENTS TO THE MENTALLY ILL OFFENDER2

TREATMENT AND CRIME REDUCTION ACT.3

(a) S AFE COMMUNITIES.—4

(1) IN GENERAL.—Section 2991(a) of title I of5

the Omnibus Crime Control and Safe Streets Act of6

1968 (42 U.S.C. 3797aa(a)) is amended—7

(A) in paragraph (7)—8

(i) in the heading, by striking ‘‘MEN-9

TAL ILLNESS’’ and inserting ‘‘MENTAL 10

ILLNESS; MENTAL HEALTH DISORDER’’;11

and12

(ii) by striking ‘‘term ‘mental illness’13

means’’ and inserting ‘‘terms ‘mental ill-14

ness’ and ‘mental health disorder’ mean’’;15

and16

(B) by striking paragraph (9) and insert-17

ing the following:18

‘‘(9) PRELIMINARILY QUALIFIED OFFENDER.—19

‘‘(A) IN GENERAL.—The term ‘prelimi-20

narily qualified offender’ means an adult or ju-21

venile accused of an offense who—22

‘‘(i)(I) previously or currently has23

been diagnosed by a qualified mental24

health professional as having a mental ill-25


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ness or co-occurring mental illness and1

substance abuse disorders;2

‘‘(II) manifests obvious signs of men-3

tal illness or co-occurring mental illness4

and substance abuse disorders during ar-5

rest or confinement or before any court; or6

‘‘(III) in the case of a veterans treat-7

ment court provided under subsection (i),8

has been diagnosed with, or manifests ob-9

vious signs of, mental illness or a sub-10

stance abuse disorder or co-occurring men-11

tal illness and substance abuse disorder;12

and13

‘‘(ii) has been unanimously approved14

for participation in a program funded15

under this section by, when appropriate,16

the relevant—17

‘‘(I) prosecuting attorney;18

‘‘(II) defense attorney;19

‘‘(III) probation or corrections20

official;21

‘‘(IV) judge; and22

‘‘(V) a representative from the23

relevant mental health agency de-24

scribed in subsection (b)(5)(B)(i).25


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‘‘(B) DETERMINATION.—In determining1

whether to designate a defendant as a prelimi-2

narily qualified offender, the relevant pros-3

ecuting attorney, defense attorney, probation or4

corrections official, judge, and mental health or5

substance abuse agency representative shall6

take into account—7

‘‘(i) whether the participation of the8

defendant in the program would pose a9

substantial risk of violence to the commu-10

nity;11

‘‘(ii) the criminal history of the de-12

fendant and the nature and severity of the13

offense for which the defendant is charged;14

‘‘(iii) the views of any relevant victims15

to the offense;16

‘‘(iv) the extent to which the defend-17

ant would benefit from participation in the18

program;19

‘‘(v) the extent to which the commu-20

nity would realize cost savings because of21

the defendant’s participation in the pro-22

gram; and23

‘‘(vi) whether the defendant satisfies24

the eligibility criteria for program partici-25


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pation unanimously established by the rel-1

evant prosecuting attorney, defense attor-2

ney, probation or corrections official, judge3

and mental health or substance abuse4

agency representative.’’.5

(2) TECHNICAL AND CONFORMING AMEND-6

MENT.—Section 2927(2) of title I of the Omnibus7

Crime Control and Safe Streets Act of 1968 (428

U.S.C. 3797s–6(2)) is amended—9

(A) by striking ‘‘has the meaning given10

that term in section 2991(a).’’ and inserting the11

following: ‘‘means an offense that—’’; and12

(B) by adding at the end the following:13

‘‘(A) does not have as an element the use,14

attempted use, or threatened use of physical15

force against the person or property of another;16

or17

‘‘(B) is not a felony that by its nature in-18

volves a substantial risk that physical force19

against the person or property of another may20

be used in the course of committing the of-21

fense.’’.22

(b) E VIDENCE-B ASED PRACTICES.—Section 2991(c)23

of title I of the Omnibus Crime Control and Safe Streets24

Act of 1968 (42 U.S.C. 3797aa(c)) is amended—25


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(1) in paragraph (3), by striking ‘‘or’’ at the1

end;2

(2) by redesignating paragraph (4) as para-3

graph (6); and4

(3) by inserting after paragraph (3) the fol-5

lowing:6

‘‘(4) propose interventions that have been7

shown by empirical evidence to reduce recidivism;8

‘‘(5) when appropriate, use validated assess-9

ment tools to target preliminarily qualified offenders10

with a moderate or high risk of recidivism and a11

need for treatment and services; or’’.12

(c) A CADEMY TRAINING.—Section 2991(h) of title I13

of the Omnibus Crime Control and Safe Streets Act of14

1968 (42 U.S.C. 3797aa(h)) is amended—15

(1) in paragraph (1), by adding at the end the16

following:17

‘‘(F) A CADEMY TRAINING.—To provide18

support for academy curricula, law enforcement19

officer orientation programs, continuing edu-20

cation training, and other programs that teach21

law enforcement personnel how to identify and22

respond to incidents involving persons with23

mental health disorders or co-occurring mental24

health and substance abuse disorders.’’; and25


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(2) by adding at the end the following:1

‘‘(4) PRIORITY CONSIDERATION.—The Attorney2

General, in awarding grants under this subsection,3

shall give priority to programs that law enforcement4

personnel and members of the mental health and5

substance abuse professions develop and administer6

cooperatively.’’.7

(d) A SSISTING V ETERANS.—Section 2991 of title I8

of the Omnibus Crime Control and Safe Streets Act of9

1968 (42 U.S.C. 3797aa) is further amended—10

(1) by redesignating subsection (i) as subsection11

(n); and12

(2) by inserting after subsection (h) the fol-13

lowing:14

‘‘(i) A SSISTING V ETERANS.—15

‘‘(1) DEFINITIONS.—In this subsection:16

‘‘(A) PEER TO PEER SERVICES OR PRO-17

GRAMS.—The term ‘peer to peer services or18

programs’ means services or programs that con-19

nect qualified veterans with other veterans for20

the purpose of providing support and21

mentorship to assist qualified veterans in ob-22

taining treatment, recovery, stabilization, or re-23

habilitation.24


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‘‘(B) QUALIFIED VETERAN.—The term1

‘qualified veteran’ means a preliminarily quali-2

fied offender who—3

‘‘(i) has served on active duty in any4

branch of the Armed Forces, including the5

National Guard and reserve components;6

and7

‘‘(ii) was discharged or released from8

such service under conditions other than9

dishonorable.10

‘‘(C) V ETERANS TREATMENT COURT PRO-11

GRAM.—The term ‘veterans treatment court12

program’ means a court program involving col-13

laboration among criminal justice, veterans, and14

mental health and substance abuse agencies15

that provides qualified veterans with—16

‘‘(i) intensive judicial supervision and17

case management, which may include ran-18

dom and frequent drug testing where ap-19

propriate;20

‘‘(ii) a full continuum of treatment21

services, including mental health services,22

substance abuse services, medical services,23

and services to address trauma;24


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‘‘(iii) alternatives to incarceration;1

and2

‘‘(iv) other appropriate services, in-3

cluding housing, transportation, mentoring,4

employment, job training, education, and5

assistance in applying for and obtaining6

available benefits.7

‘‘(2) V ETERANS ASSISTANCE PROGRAM.—8

‘‘(A) IN GENERAL.—The Attorney General,9

in consultation with the Secretary of Veterans10

Affairs, may award grants under this sub-11

section to applicants to establish or expand—12

‘‘(i) veterans treatment court pro-13

grams;14

‘‘(ii) peer to peer services or programs15

for qualified veterans;16

‘‘(iii) practices that identify and pro-17

vide treatment, rehabilitation, legal, transi-18

tional, and other appropriate services to19

qualified veterans who have been incarcer-20

ated; and21

‘‘(iv) training programs to teach22

criminal justice, law enforcement, correc-23

tions, mental health, and substance abuse24

personnel how to identify and appro-25


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priately respond to incidents involving1

qualified veterans.2

‘‘(B) PRIORITY .—In awarding grants3

under this subsection, the Attorney General4

shall give priority to applications that—5

‘‘(i) demonstrate collaboration be-6

tween and joint investments by criminal7

justice, mental health, substance abuse,8

and veterans service agencies;9

‘‘(ii) promote effective strategies to10

identify and reduce the risk of harm to11

qualified veterans and public safety; and12

‘‘(iii) propose interventions with em-13

pirical support to improve outcomes for14

qualified veterans.’’.15

(e) CORRECTIONAL F ACILITIES.—Section 2991 of16

title I of the Omnibus Crime Control and Safe Streets Act17

of 1968 (42 U.S.C. 3797aa) is further amended by insert-18

ing after subsection (i), as so added by subsection (d), the19

following:20

‘‘(j) CORRECTIONAL F ACILITIES.—21

‘‘(1) DEFINITIONS.—22

‘‘(A) CORRECTIONAL FACILITY .—The term23

‘correctional facility’ means a jail, prison, or24

other detention facility used to house people25


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who have been arrested, detained, held, or con-1

victed by a criminal justice agency or a court.2

‘‘(B) ELIGIBLE INMATE.—The term ‘eligi-3

ble inmate’ means an individual who—4

‘‘(i) is being held, detained, or incar-5

cerated in a correctional facility; and6

‘‘(ii) manifests obvious signs of a7

mental illness or has been diagnosed by a8

qualified mental health professional as hav-9

ing a mental illness.10

‘‘(2) CORRECTIONAL FACILITY GRANTS.—The11

Attorney General may award grants to applicants to12

enhance the capabilities of a correctional facility—13

‘‘(A) to identify and screen for eligible in-14

mates;15

‘‘(B) to plan and provide—16

‘‘(i) initial and periodic assessments of17

the clinical, medical, and social needs of in-18

mates; and19

‘‘(ii) appropriate treatment and serv-20

ices that address the mental health and21

substance abuse needs of inmates;22

‘‘(C) to develop, implement, and enhance—23

‘‘(i) post-release transition plans for24

eligible inmates that, in a comprehensive25


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manner, coordinate health, housing, med-1

ical, employment, and other appropriate2

services and public benefits;3

‘‘(ii) the availability of mental health4

care services and substance abuse treat-5

ment services; and6

‘‘(iii) alternatives to solitary confine-7

ment and segregated housing and mental8

health screening and treatment for inmates9

placed in solitary confinement or seg-10

regated housing; and11

‘‘(D) to train each employee of the correc-12

tional facility to identify and appropriately re-13

spond to incidents involving inmates with men-14

tal health or co-occurring mental health and15

substance abuse disorders.’’.16

(f) REAUTHORIZATION OF A PPROPRIATIONS.—Sec-17

tion 2991(n) of title I of the Omnibus Crime Control and18

Safe Streets Act of 1968, as redesignated in subsection19

(d), is amended—20

(1) in paragraph (1)—21

(A) in subparagraph (B), by striking22

‘‘and’’ at the end;23

(B) in subparagraph (C), by striking the24

period and inserting ‘‘; and’’; and25


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(C) by adding at the end the following:1

‘‘(D) $40,000,000 for each of fiscal years2

2015 through 2019.’’; and3

(2) by adding at the end the following:4

‘‘(3) LIMITATION.—Not more than 20 percent5

of the funds authorized to be appropriated under6

this section may be used for purposes described in7

subsection (i) (relating to veterans).’’.8

SEC. 403. ASSISTED OUTPATIENT TREATMENT.9

Section 2201(2)(B) of title I of the Omnibus Crime10

Control and Safe Streets Act of 1968 (42 U.S.C.11

3796ii(2)(B)) is amended by inserting before the semi-12

colon the following: ‘‘, or court-ordered assisted outpatient13

treatment (as defined in section 14(a) of the Helping14

Families in Mental Health Crisis Act of 2013) when the15

court has determined such treatment to be necessary’’.16

SEC. 404. IMPROVEMENTS TO THE DEPARTMENT OF JUS-17

TICE DATA COLLECTION AND REPORTING OF18

MENTAL ILLNESS IN CRIME.19

Notwithstanding any other provision of law, any data20

prepared by or submitted to the Attorney General or the21

Director of the Federal Bureau of Investigation on or22

after the date of enactment of this Act that is 90 days23

after the date of enactment of this Act with respect to24

the incidences of homicides, law enforcement officers killed25


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and assaulted, or individuals killed by law enforcement of-1

ficers shall include data with respect to the involvement2

of mental illness in such incidences, if any. Not later than3

90 days after the date of the enactment of this Act, the4

Attorney General shall promulgate or revise regulations as5

necessary to carry out this section.6

SEC. 405. REPORTS ON THE NUMBER OF SERIOUSLY MEN-7

TALLY ILL WHO ARE IMPRISONED.8

(a) REPORT ON THE COST OF TREATING THE MEN-9

TALLY ILL IN THE CRIMINAL JUSTICE S YSTEM.—Not10

later than 12 months after the date of enactment of this11

Act, the Comptroller General of the United States shall12

submit to Congress a report detailing the cost of imprison-13

ment for persons who have serious mental illness by the14

Federal Government or a State or local government. The15

report shall calculate the number and type of crimes com-16

mitted by persons with serious mental illness each year,17

and detail strategies or ideas for preventing crimes by18

those individuals with serious mental illness from occur-19

ring.20

(b) DEFINITION.—For purposes of this section, the21

Attorney General, in consultation with the Assistant Sec-22

retary of Mental Health and Substance Use Disorders23

shall determine an appropriate definition of ‘‘serious men-24

tal illness’’ based on the ‘‘Health Care Reform for Ameri-25


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cans with Severe Mental Illnesses: Report’’ of the National1

Advisory Mental Health Council, American Journal of2

Psychiatry 1993; 150:1447–1465.3

TITLE V—MEDICARE AND4

MEDICAID REFORMS5

SEC. 501. ENHANCED MEDICAID COVERAGE RELATING TO6

CERTAIN MENTAL HEALTH SERVICES.7

(a) MEDICAID COVERAGE OF MENTAL HEALTH 8

SERVICES AND PRIMARY C ARE SERVICES FURNISHED ON 9

THE S AME D AY .—10

(1) IN GENERAL.—Section 1902(a) of the So-11

cial Security Act (42 U.S.C. 1396a(a)) is amended12

by inserting after paragraph (77) the following new13

paragraph:14

‘‘(78) not prohibit payment under the plan for15

a mental health service or primary care service fur-16

nished to an individual at a federally qualified com-17

munity behavioral health center (as defined in sec-18

tion 1905(l)(4)) or a federally qualified health center19

(as defined in section 1861(aa)(3)) for which pay-20

ment would otherwise be payable under the plan,21

with respect to such individual, if such service were22

not a same-day qualifying service (as defined in sub-23

section (ll));’’.24


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(2) S AME-DAY QUALIFYING SERVICES DE-1

FINED.—Section 1902 of the Social Security Act (422

U.S.C. 1396a) is amended by adding at the end the3

following new subsection:4

‘‘(ll) S AME-D AY QUALIFYING SERVICES DEFINED.—5

For purposes of subsection (a)(78), the term ‘same-day6

qualifying service’ means—7

‘‘(1) a primary care service furnished to an in-8

dividual by a provider at a facility on the same day9

a mental health service is furnished to such indi-10

vidual by such provider (or another provider) at the11

facility; and12

‘‘(2) a mental health service furnished to an in-13

dividual by a provider at a facility on the same day14

a primary care service is furnished to such individual15

b

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